Provider Demographics
NPI:1255584819
Name:THOMAS, CAROLINE (LICSW)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MT DIABLO BLVD
Mailing Address - Street 2:404
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4852
Mailing Address - Country:US
Mailing Address - Phone:808-295-1740
Mailing Address - Fax:
Practice Address - Street 1:100 EILEEN DONDERO FOLEY AVE STE 302
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4597
Practice Address - Country:US
Practice Address - Phone:603-883-0005
Practice Address - Fax:603-883-0007
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286381041C0700X
RIISW031211041C0700X
NH51391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty